ICD-10 Coding for COVID-19 Infection(U07.1, Z20.828)
Complete ICD-10-CM coding and documentation guide for COVID-19 Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to COVID-19 Infection
U07.1Primary Range
COVID-19, virus identified
Primary code for confirmed COVID-19 cases with positive test results.
Contact with and (suspected) exposure to other viral communicable diseases
Used for exposure to COVID-19 without confirmed infection.
Sequelae of other specified infectious and parasitic diseases
Used for post-COVID conditions or sequelae.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| U07.1 | COVID-19, virus identified | Use for confirmed COVID-19 cases with positive test results. |
|
| Z20.828 | Contact with and (suspected) exposure to other viral communicable diseases | Use for exposure to COVID-19 without confirmed infection. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for COVID-19
Essential facts and insights about COVID-19 Infection
Primary ICD-10-CM Codes for covid infection
Decision Criteria
clinical Criteria
- Positive test result or provider confirmation
coding Criteria
- Confirmed case with documented test result
Applicable To
- Confirmed COVID-19 cases
Excludes
- Suspected COVID-19 (Z20.828)
Clinical Validation Requirements
- Positive SARS-CoV-2 NAAT/PCR or antigen test
- Provider documentation of 'confirmed COVID-19'
Code-Specific Risks
- Incorrect use for suspected cases without confirmation
Coding Notes
- Always sequence U07.1 first unless specific guidelines dictate otherwise.
Z20.828 - Contact with and (suspected) exposure to other viral communicable diseases
Use for exposure to COVID-19 without confirmed infection.
Applicable To
- Exposure to COVID-19
Excludes
- Confirmed COVID-19 (U07.1)
Clinical Validation Requirements
- Documented exposure to COVID-19
- Symptoms without confirmed test
Coding Notes
Do not use for confirmed COVID-19 cases.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Exposure to viral communicable diseases
Z20.828Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting COVID-19 Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code U07.1.
Impact
Clinical: Misrepresentation of patient status., Regulatory: Potential audit issues., Financial: Claim denials due to insufficient documentation.
Mitigation Strategy
Always document test results clearly.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on COVID-19 case counts.
Mitigation Strategy
Use Z20.828 for suspected cases without confirmation.
Impact
Using U07.1 without confirmation.
Mitigation Strategy
Ensure documentation of positive test or provider confirmation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for COVID-19 Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for COVID-19 Infection
Use these documentation templates to ensure complete and accurate documentation for COVID-19 Infection. These templates include all required elements for proper coding and billing.
Confirmed COVID-19 with pneumonia
Specialty: PulmonologyRequired Elements
- Positive test result
- Imaging findings
- Symptoms and clinical course
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for COVID-19 Infection? Ask your questions below.